[Cardiac arrest due to lidocaine]. 1989

S Mishima, and K Kasai, and M Yamamoto, and K Kitoh, and H Fujita

A 65-year-old woman with height of 156 cm and weight of 54 kg, who had previously been healthy, was scheduled for resection of axillary abscess. She was not premedicated. After local infiltration of 1%-lidocaine 25 ml, operation was started under electrocardiographic monitoring. Blood pressure was 190/100 mmHg, heart rate being 80 bpm and EKG showed sinus rhythm. During next 25 minutes, 60 ml of 1%-lidocaine was used because of inadequate pain relief. Two minutes after the last injection of 1%-lidocaine 10 ml, the patient developed significant bradycardia followed by cardiac standstill. Resuscitation was started immediately. Within two minutes, EKG showed idioventricular rhythm followed by junctional escaped rhythm and then sinus rhythm at a rate of 42 bpm appeared. Bradycardia below 50 bpm continued for 9 minutes despite of intravenous administration of atropine. After the recovery of heart beat, the patient became responsive, alert, and oriented, and neither arrhythmia nor ST-T change was observed. Laboratory data showed no abnormality which might have predisposed her to the development of cardiac arrest. Because the cardiac arrest occurred soon after lidocaine injection and no drug other than lidocaine had been used, lidocaine was thought to be the cause of the cardiac arrest.

UI MeSH Term Description Entries
D008012 Lidocaine A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE. Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D005260 Female Females
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics

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